Neisseria gonorrhoeae Antimicrobial Susceptibility in Lilongwe, Malawi, 2007

作者：Lillian B. Brown, Robert Krysiak, Gift Kamanga, Clemente Mapanje, Happiness Kanyamula, Blessings Banda, Chisale Mhango, M S Hoffman, Debbie Kamwendo, Marcia M. Hobbs, Mina C. Hosseinipour, Francis Martinson, Myron S. Cohen, Irving Hoffman · 发表于：Sexually Transmitted Diseases · 年份：2010 · DOI：10.1097/olq.0b013e3181bf575c · 被引用次数：124 · 研究领域：Reproductive tract infections research、Bacterial Infections and Vaccines、Neonatal and Maternal Infections

BACKGROUND: Malawi adopted syndromic management of sexually transmitted infections in 1993. Based on clinical efficacy and cost, gentamicin 240 mg intramuscularly, and doxycycline 100 mg twice daily x 7 days was selected as the first line regimen to treat urethritis. We sought to establish current laboratory-based Neisseria gonorrhoeae antibiotic susceptibility patterns for Malawi and describe the pattern of susceptibility since syndromic management began. METHODS: Between May 15 and August 10, 2007, 126 men with urethritis attending the STD clinic at Kamuzu Central Hospital in Lilongwe had history, genital exam, and urethral swabs taken. All were treated with gentamicin and doxycycline in accordance with Malawi guidelines. Gonorrhea was diagnosed by Gram stain and culture. Antimicrobial susceptibility patterns in gonococcal isolates were determined by disk diffusion and E-test minimum inhibitory concentration (MIC) determination and agar dilution MIC determination. RESULTS: One hundred six isolates were cultured, and MICs were determined for 100. High levels of resistance to tetracycline and penicillin were observed, but isolates were uniformly susceptible to both gentamicin and ciprofloxacin. Susceptibility patterns identified by the agar dilution MIC and E-test MIC agreed. CONCLUSIONS: The most recent study continues the trend of high susceptibility of gonococcal isolates to gentamicin in Malawi after 14 years of use and suggests agar dilution MICs may be substituted with ...